title: [Development and first results of fast and cost-effective examination methods for an ophthalmological screening within the National Cohort].
abstract: BACKGROUND
  For an implemented ophthalmological screening within a German long-term cohort study (National Cohort) simple and effective methods for an examination of visual acuity and for non-mydriatic retina photografies should be evaluated. Furthermore standard operating-procedures (SOP) should be developed.
  
  
  METHODS
  In the years 2011 and 2012 pinhole visual acuity measurements and automated retina photographies (DRS, CenterVue S. p. a., Padua, Italy) were made at three different epidemiological study centers within Germany. Furthermore, anterior segment images were taken by the camera. Standard operating procedures (SOP) regarding the ophthalmological screening were developed and evaluated within the study. The main question was whether it is possible to implement the screening methods within the National Cohort. Further main outcomes were quality and interpretability of the taken images.
  
  
  RESULTS
  457 subjects (914 eyes) were examined within the investigation. Median VA was 0.8 for right and left eyes (p > 0.42). Image quality of the photographies was good in 491 cases (54 %), fair in 239 cases (26 %) and bad in 179 cases (20 %). The usability of the images was without limitations in 686 cases (75 %), limited in 152 cases (17 %) and not given in 71 cases (8 %). Increasing age of the subjects was slightly correlated with decreasing image quality (r = 0.26) and decreasing image usability (r = 0.2). Anterior segment photographies were usable in 176 eyes (56 %).
  
  
  CONCLUSIONS
  The developed screening method fulfilled the specifications of the National Cohort. The used pinhole visual acuity examination was fast and cheap. Image quality and usability of the retina photographies could be improved with prolonged pupil recovery times. The quality of the anterior segment images could not fulfill the expectations and were taken out of the further examinations of the ophthalmological screening. The written SOP showed good acceptance within the investigators' daily routine. The ophthalmological screening within the National Cohort generates information (e. g., pathologies of the vessels or of the retina) which are useful not only from an ophthalmological point of view.
authors.affiliation: Department für Augenheilkunde, Universitäts-Augenklinik Tübingen.
authors.forename: M A
authors.initials: MA
authors.lastname: Leitritz
authors.forename: H-W
authors.initials: HW
authors.lastname: Hense
authors.forename: U
authors.initials: U
authors.lastname: Schiefer
authors.forename: M
authors.initials: M
authors.lastname: Nagel
authors.forename: H
authors.initials: H
authors.lastname: Greiser
authors.forename: J
authors.initials: J
authors.lastname: Linseisen
authors.forename: I
authors.initials: I
authors.lastname: Heid
authors.forename: B
authors.initials: B
authors.lastname: Fischer
authors.forename: S
authors.initials: S
authors.lastname: Thierry
authors.forename: K U
authors.initials: KU
authors.lastname: Bartz-Schmidt
authors.forename: M
authors.initials: M
authors.lastname: Ueffing
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D010865:Pilot Projects; D015203:Reproducibility of Results; D042262:Retinoscopy / Q000191:economics* / Q000379:methods; D012680:Sensitivity and Specificity; D014786:Vision Disorders / Q000175:diagnosis* / Q000191:economics* / Q000517:prevention & control; D014787:Vision Tests / Q000191:economics* / Q000379:methods; D055815:Young Adult